Objective: To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT).
Methods: A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared.
Results: Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased (P<0.05), and NO was increased (P<0.05) in the two groups; FPG, 2hPG, FINS and HOMA-IR after treatment were decreased in the IGT group (P<0.05), the improvement of the above indexes in the IGT group was more significant than that in the NGT group (P<0.05). After treatment, the serum levels of ADMD, ET-1 and MDA were decreased (P<0.05), and NO was increased (P<0.05) in the obese subgroup. In the IGT group, the improvement of serum ADMD, ET-1, MDA and NO in the obese subgroup was more significant than that in the non-obese subgroup (P<0.05). In the NGT group, the improvement of ET-1, MDA and NO in the obese subgroup was more significant than that in the non-obese subgroup (P<0.05).
Conclusion: Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.
目的：观察针刺对糖耐量异常（IGT）与正常糖耐量（NGT）多囊卵巢综合征（PCOS）患者血管内皮功能的影响。方法：根据糖耐量情况将140例PCOS患者分为IGT组（70例，脱落11例）、NGT组（70例，脱落9例）。两组均采用全周期针刺，针刺中脘、关元、气海、天枢等穴，隔日1次，每周3次，连续治疗3个月。于治疗前后比较两组中医症状评分、胰岛素抵抗指标[空腹血糖（FPG）、2 h血糖（2hPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）]及血管内皮相关因子[不对称二甲精氨酸（ADMD）、内皮素1（ET-1）、丙二醛（MDA）、一氧化氮（NO）]，并进行组内肥胖与非肥胖亚组比较。结果：两组治疗后中医症状评分、ADMD、ET-1、MDA均降低（P<0.05），NO升高（P<0.05），IGT组患者治疗后FPG、2hPG、FINS、HOMA-IR均降低（P<0.05）、IGT组以上指标改善幅度均大于NGT组（P<0.05）。两组内肥胖亚组治疗后血清ADMD、ET-1、MDA均降低（P<0.05），NO升高（P<0.05）；IGT组肥胖亚组血清ADMD、ET-1、MDA、NO改善幅度大于非肥胖组（P<0.05）；NGT组肥胖亚组血清ET-1、MDA、NO改善幅度大于非肥胖亚组（P<0.05）。结论：针刺能改善PCOS患者血管内皮功能，且在改善程度上IGT患者优于NGT患者，肥胖患者优于非肥胖患者。.
Keywords: acupuncture; asymmetric dimethylarginine (ADMD); endothelin-1 (ET-1); impaired glucose tolerance; insulin resistance; malondialdehyde (MDA); nitric oxide (NO); polycystic ovary syndrome.